Patient Access Coordinator - Main Admitting and Reg

Overview

Obtain and verify appropriate personal, demographic and financial information for the purposes of ensuring (1) quality patient care through proper patient identification and (2) maximal reimbursement for all billable clinical services rendered. Scan the appropriate identification documents into OnBase. Obtain EMTALA notification signature. Notify clinical staff when patients present with a critical condition. Once verified, place appropriate insurance information on the account.

• Analytical
  
  Skills:
  
  Analyze patient accounts; evaluate financial data for establishment of current accounts and document actions taken regarding accounts to maximize reimbursement. Maintain knowledge of current HMO/PPO/Medicaid/Medicare/commercial insurance regulations and requirements. Determine all insurance coverage (primary, secondary, tertiary, etc.). Complete required MSPQ questionnaires for all appropriate patients. Obtain and document clinical referrals from other providers. Coordinate patients in need of financial assistance with the appropriate Financial Counselor.
  
  Collect and deposit, according to specified protocols, all required and mandatory insurance co-payments. Initiate online verification of third party Insurance Carriers and Plan Administrators to verify patient benefits. Evaluate and prepare chart documentation to establish that Medical Necessity guidelines have been met. Prepare and complete documentation that establishes Medicare Compliance such as Medicare Secondary Payor Questionnaire and Advance Beneficiary Notice.
  
  Document appropriate data in account documentation and guarantor notes.
• Clinical
  
  Skills:
  
  Process Emergency and Obstetrics by notifying appropriate staff. Answer and direct incoming calls from Physician’s office staff, ancillary departments and other facilities. Answer inquiries concerning hospital policies.
• Compliance
  
  Skills:
  
  Obtain signatures for the visit for all revenue cycle documentation. Prepare charts, collected forms and photocopies (insurance cards) and documentation. Distribute, witness by signature and collect patient advanced directive forms/information; refer patients to appropriate personnel to address specific questions as indicated. Provide patients with information about their rights and responsibilities and all other duties as assigned.
• Communication/Interpretation
  
  Skills:
  
  Interview patients and obtain, verify and enter into the database complete and accurate demographic and financial information. Assess and update information as it relates to each encounter. Determine financial plan and coverage priority. (Data collected directly impacts financial and clinical systems.) Maintain facility productivity standards and Patient Accounts Quality Guidelines (e.g., 100% accuracy of 95% of all registrations). Communicate effectively and meet or exceed established customer service goals.
• Education and Leadership
  
  Skills:
  
  Provide education and training/mentoring for other staff members. Attend department meetings and review procedural & process changes per facility guidelines.

KNOWLEDGE AND SKILLS: Please describe any specialized knowledge or skills required to perform the position duties. Do not personalize the job description, credentials, or knowledge and skills based on the current associate. List any special education required for this position.

EDUCATION: High School Diploma;
Associate’s Degree preferred or equivalent combination of education and experience.

YEARS OF EXPERIENCE: One to three years of experience in Registration, Billing, Customer Service, or Managed Care Organization work environments. Must have/gain knowledge of Hospital Medical Staff rules and infection control policies to be effective in this position.

REQUIRED SKILLS AND KNOWLEDGE: Analytical skills required to make decisions based on the facility and clinical situation puter literacy – use of multiple systems (Epic, Passport, OnBase, Microsoft Office products and Midas). Ability to use Internet Access and utilize third party payor systems for eligibility and verification. Knowledge of health insurance coverage and requirements. Excellent communication, problem solving skills, and ability to deal with customers who are often adversarial.

Ability to be flexible, organized and function well in stressful situations. Ability to interact independently to resolve Customer Service issues. Must understand medical terminology and acuity levels.

LICENSES & CERTIFICATIONS: Annual Registration Competency Review with 95% or greater score obtained. Yearly STAT testing completed.